High Risk of Low Anterior Resection Syndrome in Long-term Follow-up after Anastomotic Leakage in Anterior Resection for Rectal Cancer

BACKGROUND Low anterior resection syndrome (LARS) is a common functional disorder that develops after patients with rectal cancer undergo anal preservation surgery. Common approaches to assess the symptoms of patients with LARS are often complex and time consuming. Instant messaging social media (IMSM) has great application potential in low anterior resection syndrome (LARS) follow-up, but has been underdeveloped. OBJECTIVE To compare data from a novel instant messaging social media (IMSM) follow-up system and a telephone interview (TI) in patients with low anterior resection syndrome (LARS) and to analyse the consistency of the IMSM platform. METHODS R0-resectable rectal cancer patients who accepted several defecation function visits via the IMSM platform and a telephone interview (TI) after the operation using the same questionnaire, including subjective questions and LARS scores, were included. Differences between the two methods were analysed in pairs and the diagnostic consistency of IMSM was calculated based on TI results. RESULTS In total, 21 questionnaires from 15 patients were included. The positive rates of defecation satisfaction, life restriction and medication use were 52.4%, 52.4%, 38.1% for TI and 52.4%, 61.9%, 23.8% for IMSM, respectively. No statistically significant difference was observed between IMSM and TI in terms of total LARS score (22.4 ± 11.9 vs 24.7 ± 10.7,P < 0.213) and LARS categories (Z = −0.264, P = 0.792); however, IMSM showed a more negative tendency. The Kappa values of three subjective questions were 0.618, 0.430 and 0.674, respectively. The total LARS scores were consistent between both groups (Pearson coefficient 0.760, P < 0.001; category correlation coefficient 0.570, P = 0.005). Patients with major LARS had highly consistent results, with sensitivity, specificity, kappa value and p of 77.8%, 91.7%, 0.704 and 0.001, respectively. CONCLUSIONS IMSM can be a significant LARS screening method. However, further research on information accuracy and user acceptance is needed before implementing a mature application. CLINICALTRIAL This study is a subproject of the registered study Bas-1611, which was registered on ClinicalTrail.org website and numbered NCT03009747 in January 2017.

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Long-term oncological outcomes of low anterior resection for rectal cancer with and without preservation of the left colic artery: a retrospective cohort study

BMC Cancer ◽

10.1186/s12885-021-07848-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuwen Luo ◽

Rongjiang Li ◽

Deqing Wu ◽

Jun Zeng ◽

Junjiang Wang ◽

...

Keyword(s):

Rectal Cancer ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Colic Artery ◽

Early Complications ◽

Left Colic Artery ◽

Oncological Outcomes

Abstract Background There is uncertainty in the literature about preserving the left colic artery (LCA) during low anterior resection for rectal cancer. We analyzed the effect of preserving the LCA on long-term oncological outcomes. Methods We retrospectively collected clinicopathological and follow-up details of patients who underwent low anterior resection for rectal cancer in the General Surgery Department of Guangdong Provincial People’s Hospital, from January 2014 to December 2015. Cases were divided into low ligation (LL), LCA preserved, or high ligation (HL), LCA not preserved, of the inferior mesenteric artery. The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the two groups. Results Altogether, there were 221 and 295 cases in the LL group and HL groups, respectively. Operating time in the LL group was significantly longer than in the HL group (224.7 vs. 211.7 min, p = 0.039). Postoperative 30-day mortality, early complications including anastomotic leakage showed no significant differences between the LL and HL groups (postoperative 30-day mortality, 0.9% LL, 1.4% HL, p = 0.884; early complications, 41.2% LL, 38.3% HL, p = 0.509; anastomotic leakage 8.6% LL, 13.2% HL, p = 0.100). The median follow-up periods were 51.4 (7–61) months in the LL group and 51.2 (8–61) months in the HL group. During follow-up, the percentages of patients who died, had local recurrence, or had metastases were 39.8, 7.7, and 38.5%, respectively, in the LL group and 39, 8.5, and 40%, respectively, in the HL group; these differences were not significant (all p > 0.05). The 5-year OS and DFS were 69.6 and 59.6% in the LL group, respectively, and 69.1 and 56.2% in the HL group, respectively; these differences were not significant (all p > 0.05). After stratification by tumor-node-metastasis stage, the difference between the 5-year OS and DFS for stages I, II, and III cancer were not significant (all p > 0.05). Conclusions The long-term oncological outcomes of LL group are comparable with HL group. LL cannot be supported due to the absence of lower complication rates and the longer operating times.

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Anterior Resection Syndrome and Quality of Life with Long-term Follow up After Rectal Cancer Resection

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000002107 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Stella Dilke ◽

Christopher Hadjittofi ◽

Mary Than ◽

Phil Tozer ◽

Adam T. Stearns

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Anterior Resection ◽

Cancer Resection ◽

Anterior Resection Syndrome ◽

Rectal Cancer Resection ◽

Long Term Follow Up

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Comparative analysis of the Memorial Sloan Kettering Bowel Function Instrument and the Low Anterior Resection Syndrome Questionnaire for assessment of bowel dysfunction in rectal cancer patients after low anterior resection

Colorectal Disease ◽

10.1111/codi.15515 ◽

2021 ◽

Author(s):

Felipe F. Quezada‐Diaz ◽

Hossam Elfeki ◽

Katrine J. Emmertsen ◽

Emmanouil P. Pappou ◽

Rosa Jimenez‐Rodriguez ◽

...

Keyword(s):

Rectal Cancer ◽

Comparative Analysis ◽

Cancer Patients ◽

Anterior Resection ◽

Low Anterior Resection ◽

Bowel Function ◽

Bowel Dysfunction ◽

Low Anterior Resection Syndrome ◽

Anterior Resection Syndrome

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The impact of timing of stoma closure on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer

Kurdistan Journal of Applied Research ◽

10.24017/science.2021.1.13 ◽

2021 ◽

pp. 126-134

Author(s):

Hemn Hussain Kaka Ali ◽

Qalandar Hussein Abdulkarim ◽

Karzan Seerwan ◽

Barham M. M .Salih

Keyword(s):

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Anal Verge ◽

Loop Ileostomy ◽

Low Anterior Resection Syndrome ◽

Anterior Resection Syndrome ◽

Closure Of Ileostomy ◽

The Mean ◽

The Impact

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus. A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.

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